New Vaccination Guidelines: HepB for Diabetics; HPV for Young Men

By Susan H. Scher

There were a number of changes to the 2012 clinical guidelines that doctors follow for adult immunizations, released by a federal panel.

The Advisory Committee on
Immunization Practices (ACIP), the federal panel responsible for setting
guidelines for use of vaccines in the United States, has issued
its 2012 clinical guidelines for adult immunizations. Doctors refer to the guidelines when recommending vaccinations for their patients.

There were significant changes to the vaccinations recommended for young men and boys, pregnant women, and diabetics.

HEPB FOR DIABETICS

Hepatitis B vaccination
is now recommended for adult diabetics under the age of 60. This
recommendation is based on the fact that diabetics have more than twice
the risk of contracting hepatitis B than do non-diabetics.

The ACIP advises that for diabetics over 60, the decision to
vaccinate be made on an individual basis, taking into account the
patient's overall medical condition. This recommendation reflects the
lower rates of effectiveness of the vaccine in older, frailer people. In
general, the more robust a patient's health, the greater the likelihood
that he or she will respond to the vaccine.

HPV FOR MALES

The new guidelines extend the call for routine vaccination against human papillomavirus (HPV) to all boys and young men between the ages of 11 and 21. The HPV
vaccine has already been recommended for females aged 11 to 26. HPV
vaccination is also recommended for men up to age 26 who engage in
same-sex relations.

TDAP IN PREGNANCY

The ACIP now advises that pregnant women receive the tetanus, diptheria, and pertussis
(Tdap) vaccine after 20 weeks' gestation. The previous recommendation
called for vaccination of the mother after delivery. The change in
timing allows the fetus to benefit from the mother's immune response
prior to birth. The new recommendation supplements existing guidelines
that call for vaccinating family members and other close contacts of
children less than 12 months old.

The guidelines were published in Annals of Internal Medicine. More information about the updated guidelines is available at the Centers for Disease Control and Prevention (CDC) website.